TX HHS Form H1837. Physician's Statement of Permanent Disability

The Physician's Statement of Permanent Disability (Form H1837) is a crucial document that helps determine eligibility for benefits through the Supplemental Nutrition Program (SNAP). This form is typically completed by physicians in situations where an individual has applied for SNAP benefits and requires assessment of their permanent disability status.

This form requires the physician to check the appropriate box(es) and provide information about the patient's condition. The conditions listed on the form include permanent loss of limb function, amputations, total deafness, statutory blindness, IQ scores below 59, spinal cord or nerve root lesions, muscular dystrophy, impaired renal function, and acquired immune deficiency syndrome. The physician is responsible for signing and dating the form, which must be returned to the eligibility determination office.

The key features of this form include the required information about the patient's condition, the various conditions that are considered permanently disabling, and the responsibilities of the physician in completing the form. By using Form H1837, physicians can help determine an individual's eligibility for SNAP benefits and provide important information to support their application.

• This form is used to determine eligibility for Supplemental Nutrition Program (SNAP) benefits.
• The form requires the physician to check the appropriate box(es) and provide information about the patient's condition.
• The conditions listed on the form include permanent loss of limb function, amputations, total deafness, statutory blindness, IQ scores below 59, spinal cord or nerve root lesions, muscular dystrophy, impaired renal function, and acquired immune deficiency syndrome.